晚期非小细胞肺癌维持治疗进展

Recearch progress of maintenance therapy in andvanced non-small cell lung cancer

目的:回顾非小细胞肺癌维持治疗的研究现状,探讨维持治疗在晚期肺癌治疗中的临床意义及如何选择最佳维持治疗方案。方法:应用PubMed和CNKI期刊全文数据库检索系统,检索2003-01-2013-05以"非小细胞肺癌、维持治疗、化疗和靶向治疗"为关键词的相关文献,共145篇。纳入标准:1)晚期非小细胞肺癌同药维持治疗;2)晚期非小细胞肺癌换药维持治疗;3)非小细胞肺癌化疗;4)非小细胞肺癌分子靶向治疗。根据纳入标准分析文献38篇。结果:一线治疗之后肿瘤有迅速进展的风险。通过复习文献发现,一线治疗结束后即刻应用维持治疗能够显著延长无进展生存率(progression-free survival,PFS),但只有培美曲塞、厄罗替尼和贝伐单抗的维持治疗获得总生存时间(overall survival,OS)的延长,且安全性较好。结论:综合考虑患者身体状态、疾病类型和基因状态等各方面因素制定个体化维持治疗方案,能为一线治疗后病情好转或稳定的晚期非小细胞肺癌患者带来进一步的临床获益。

OBJECTIVE：To review the evolution of maintenance therapy in an aim to discuss the clinical significance of maintenance therapy in andvanced non-small cell lung cancer and how to choose the best regimens.METHODS：One hundred and forty-five papers were searched with＂non-small cell lung Carcinoma＂and＂maintenance chemotherapy＂and ＂targeted therapy＂as key words within PubMed and CNKI database retrieval systems from January 2003to May 2013, and 38were finally selected according to the inclusion criteria as follows：1）Continuation maintenance therapy of vanced non-small cell lung cancer;2）Switch maintenance therapy of vanced non-small cell lung cancer;3）Chemotherapy of vanced non-small cell lung cancer;4）Targeted therapy of vanced non-small cell lung cancer.RESULTS：It is clear that maintenance therapy can prolong progression-free survival（PFS）,but only pemetrexed,erlotinib and bevacizumab are proved to obtain extension of the overall survival（OS）in maintenance therapy.CONCLUSION：Individualized maintenance therapy,which taken the maintenances of patient＇s physical condition,the histopathological type and gene status into consideration can lead to further clinical benefit in NSCLC patients after receiving standard first-line chemotherapy.